| Authors: |
Krenzien, F.; Schmelzle, M.; Pratschke, J.; Feldbrügge, L.; Liu, R.; Liu, Q.; Zhang, W.; Zhao, J. J.; Tan, H. L.; Cipriani, F.; Hoogteijling, T. J.; Aghayan, D. L.; Fretland, Å A.; Siow, T. F.; Lim, C.; Scatton, O.; Herman, P.; Coelho, F. F.; Marino, M. V.; Mazzaferro, V.; Chiow, A. K. H.; Sucandy, I.; Ivanecz, A.; Choi, S. H.; Lee, J. H.; Gastaca, M.; Vivarelli, M.; Giuliante, F.; Dalla Valle, B.; Ruzzenente, A.; Yong, C. C.; Chen, Z.; Yin, M.; Fondevila, C.; Efanov, M.; Morise, Z.; Di Benedetto, F.; Brustia, R.; Dalla Valle, R.; Boggi, U.; Geller, D.; Belli, A.; Memeo, R.; Gruttadauria, S.; Mejia, A.; Park, J. O.; Rotellar, F.; Choi, G. H.; Robles-Campos, R.; Wang, X.; Sutcliffe, R. P.; Hasegawa, K.; Tang, C. N.; Chong, C. C. N.; Lee, K. F.; Meurs, J.; D'Hondt, M.; Monden, K.; Lopez-Ben, S.; Kingham, T. P.; Ferrero, A.; Ettorre, G. M.; Pascual, F.; Cherqui, D.; Zheng, J.; Liang, X.; Soubrane, O.; Wakabayashi, G.; Troisi, R. I.; Cheung, T. T.; Kato, Y.; Sugioka, A.; Dokmak, S.; D'Silva, M.; Han, H. S.; Nghia, P. P.; Long, T. C. D.; Hilal, M. A.; Chen, K. H.; Fuks, D.; Aldrighetti, L.; Edwin, B.; Goh, B. K. P.; and International robotic and laparoscopic liver resection study group investigators |
| Article Title: |
Propensity score-matching analysis comparing robotic versus laparoscopic limited liver resections of the posterosuperior segments: An international multicenter study |
| Abstract: |
Objective: The purpose of this study was to compare the outcomes of robotic limited liver resections (RLLR) versus laparoscopic limited liver resections (LLLR) of the posterosuperior segments. Background: Both laparoscopic and robotic liver resections have been used for tumors in the posterosuperior liver segments. However, the comparative performance and safety of both approaches have not been well examined in the existing literature. Methods: This is a post hoc analysis of a multicenter database of 5446 patients who underwent RLLR or LLLR of the posterosuperior segments (I, IVa, VII, and VIII) at 60 international centers between 2008 and 2021. Data on baseline demographics, center experience and volume, tumor features, and perioperative characteristics were collected and analyzed. Propensity score-matching (PSM) analysis (in both 1:1 and 1:2 ratios) was performed to minimize selection bias. Results: A total of 3510 cases met the study criteria, of whom 3049 underwent LLLR (87%), and 461 underwent RLLR (13%). After PSM (1:1: And 1:2), RLLR was associated with a lower open conversion rate [10 of 449 (2.2%) vs 54 of 898 (6.0%); P=0.002], less blood loss [100 mL [IQR: 50-200) days vs 150 mL (IQR: 50-350); P<0.001] and a shorter operative time (188 min (IQR: 140-270) vs 222 min (IQR: 158-300); P<0.001]. These improved perioperative outcomes associated with RLLR were similarly seen in a subset analysis of patients with cirrhosis-lower open conversion rate [1 of 136 (0.7%) vs 17 of 272 (6.2%); P=0.009], less blood loss [100 mL (IQR: 48-200) vs 160 mL (IQR: 50-400); P<0.001], and shorter operative time [190 min (IQR: 141-258) vs 230 min (IQR: 160-312); P=0.003]. Postoperative outcomes in terms of readmission, morbidity and mortality were similar between RLLR and LLLR in both the overall PSM cohort and cirrhosis patient subset. Conclusions: RLLR for the posterosuperior segments was associated with superior perioperative outcomes in terms of decreased operative time, blood loss, and open conversion rate when compared with LLLR. © 2024 Lippincott Williams and Wilkins. All rights reserved. |
| Keywords: |
adult; aged; retrospective studies; major clinical study; clinical feature; clinical trial; liver cirrhosis; liver neoplasms; comparative study; laparoscopy; morbidity; pathology; retrospective study; postoperative complication; postoperative complications; length of stay; multicenter study; liver tumor; operation duration; patient safety; reoperation; surgical mortality; hepatectomy; perioperative period; hospital readmission; laparoscopic liver resection; post hoc analysis; clinical outcome; demographics; wedge resection; in-hospital mortality; propensity score; conversion to open surgery; operative blood loss; humans; human; male; female; article; segmentectomy; low volume hospital; robotic surgical procedures; robot assisted surgery; american society of anaesthesiologists score; robotic liver resection; minimally-invasive hepatectomy; posterosuperior liver segments; laparoscopic limited liver resection; robotic limited liver resection
|
| Journal Title: |
Annals of Surgery
|
| Volume: |
279 |
| Issue: |
2 |
| ISSN: |
0003-4932 |
| Publisher: |
Lippincott Williams & Wilkins
|
| Date Published: |
2024-02-01 |
| Start Page: |
297 |
| End Page: |
305 |
| Language: |
English |
| DOI: |
10.1097/sla.0000000000006027
|
| PUBMED: |
37485989
|
| PROVIDER: |
scopus
|
| DOI/URL: |
|
| Notes: |
Article -- Source: Scopus |
